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Gookin JL, Holmes J, Clarke LL, Stauffer SH, Meredith B, Vandewege MW, Torres-Machado N, Friedenberg SG, Seiler GS, Mathews KG, Meurs K. Acquired dysfunction of CFTR underlies cystic fibrosis-like disease of the canine gallbladder. Am J Physiol Gastrointest Liver Physiol 2024; 327:G513-G530. [PMID: 39041675 DOI: 10.1152/ajpgi.00145.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024]
Abstract
Mucocele formation in dogs is a unique and enigmatic muco-obstructive disease of the gallbladder caused by the amassment of abnormal mucus that bears striking pathological similarity to cystic fibrosis. We investigated the role of cystic fibrosis transmembrane conductance regulatory protein (CFTR) in the pathogenesis of this disease. The location and frequency of disease-associated variants in the coding region of CFTR were compared using whole genome sequence data from 2,642 dogs representing breeds at low-risk, high-risk, or with confirmed disease. Expression, localization, and ion transport activity of CFTR were quantified in control and mucocele gallbladders by NanoString, Western blotting, immunofluorescence imaging, and studies in Ussing chambers. Our results establish a significant loss of CFTR-dependent anion secretion by mucocele gallbladder mucosa. A significantly lower quantity of CFTR protein was demonstrated relative to E-cadherin in mucocele compared with control gallbladder mucosa. Immunofluorescence identified CFTR along the apical membrane of epithelial cells in control gallbladders but not in mucocele gallbladder epithelium. Decreases in mRNA copy number for CFTR were accompanied by decreases in mRNA for the Cl-/[Formula: see text] exchanger SLC26A3, K+ channels (KCNQ1, KCNN4), and vasoactive intestinal polypeptide receptor (VIPR1), which suggest a driving force for change in secretory function of gallbladder epithelial cells in the pathogenesis of mucocele formation. There were no significant differences in CFTR gene variant frequency, type, or predicted impact comparing low-risk, high-risk, and definitively diagnosed groups of dogs. This study describes a unique, naturally occurring muco-obstructive disease of the canine gallbladder, with uncanny similarity to cystic fibrosis, and driven by the underlying failure of CFTR function.NEW & NOTEWORTHY Cystic fibrosis transmembrane conductance regulatory protein (CFTR) genomic variants and expression of mRNA, protein, and electrogenic anion secretory activity of CFTR were characterized in dog gallbladder. Acquired inhibition of CFTR expression by gallbladder epithelium was identified as underpinning a naturally occurring muco-obstructive disease of the dog gallbladder that bears striking pathological similarity to animal models of cystic fibrosis.
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Affiliation(s)
- Jody L Gookin
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Jenny Holmes
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Lane L Clarke
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri, United States
| | - Stephen H Stauffer
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Bryanna Meredith
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Michael W Vandewege
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Nicole Torres-Machado
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Steven G Friedenberg
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, United States
| | - Gabriela S Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Kyle G Mathews
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Kathryn Meurs
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
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Gookin JL, Jewell DE, Aicher KM, Seiler GS, Cullen JM, Mathews KG. Increased lipogenesis and lipidosis of gallbladder epithelium in dogs with gallbladder mucocele formation. PLoS One 2024; 19:e0303191. [PMID: 38924032 PMCID: PMC11207163 DOI: 10.1371/journal.pone.0303191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/19/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Gallbladder disease in people is frequently associated with disorders of lipid metabolism and metabolic syndrome. A recently emergent gallbladder disease of dogs, referred to as mucocele formation, is characterized by secretion of abnormal mucus by the gallbladder epithelium and is similarly associated with hyperlipidemia, endocrinopathy, and metabolic dysfunction. The cause of gallbladder mucocele formation in dogs is unknown. METHODS A prospective case-controlled study was conducted to gain insight into disease pathogenesis by characterization of plasma lipid abnormalities in 18 dogs with gallbladder mucocele formation and 18 age and breed matched control dogs using direct infusion mass spectrometry for complex plasma lipid analysis. This analysis was complemented by histochemical and ultrastructural examination of gallbladder mucosa from dogs with gallbladder mucocele formation and control dogs for evidence of altered lipid homeostasis of the gallbladder epithelium. RESULTS Gallbladder mucocele formation in dogs carried a unique lipidomic signature of increased lipogenesis impacting 50% of lipid classes, 36% of esterified fatty acid species, and 11% of complex lipid species. Broad enrichment of complex lipids with palmitoleic acid (16:1) and decreased abundance within complex lipids of presumptive omega-3 fatty acids eicosapentaenoic (20:5) and docosahexaenoic (22:6) was significant. Severe lipidosis of gallbladder epithelium pinpoints the gallbladder as involved causally or consequently in abnormal lipid metabolism. CONCLUSION Our study supports a primary increase in lipogenesis in dogs with mucocele formation and abnormal gallbladder lipid metabolism in disease pathogenesis.
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Affiliation(s)
- Jody L. Gookin
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America
| | - Dennis E. Jewell
- Department of Grain Science and Industry, Kansas State University, Manhattan, KS, United States of America
| | - Kathleen M. Aicher
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A & M University, College Station, TX, United States of America
| | - Gabriela S. Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America
| | - John M. Cullen
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America
| | - Kyle G. Mathews
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America
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Dini R, Gori E, Habermaass V, Lippi I, Citi S, Puccinelli C, Marchetti V. An Association between Pancreatic and Cholestatic Biliary Disorders in Dogs. Animals (Basel) 2024; 14:795. [PMID: 38473180 DOI: 10.3390/ani14050795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Canine chronic biliary tree disease (CBTD) is a suspected risk factor for pancreatic injury. The aim of this study was to evaluate the frequency and features of pancreatic involvement in canine CBTD, and their relationship with hyperlipemia and its severity. CBTD was defined as the increase in at least two of ALP, GGT, total bilirubin, cholesterol, and a biliary tree abnormal abdominal ultrasound (graded mild to severe). Pancreatic ultrasound appearance was recorded and classified as acute/chronic. Dogs were divided into a PBD group (pancreatic and biliary disease) and BD group (only biliary tree disease). PBD group was subgraded into a "pancreatic injury" and "pancreatitis" group. Eighty-one dogs were retrospectively included: 56 in the PBD group and 25 in the BD group. Of the PBD group, 20 had pancreatitis (15 chronic and 5 dogs acute). US score was mild in 64 dogs and moderate in 17 dogs, and it was not associated with evidence of pancreopathy. Sixty-six dogs had hyperlipemia (mild = 27 dogs; moderate-to-severe = 39 dogs) and no association with pancreopathy was found. Pancreatic injury was more frequent than pancreatitis in CBTD dogs. Although both acute and chronic pancreatic injury may be present, chronic forms were more frequent. Pancreatic injury should be considered in CBTD patients due its possible clinical significance.
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Affiliation(s)
- Rebecca Dini
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Via Livornese Lato Monte, San Piero a Grado, 56122 Pisa, Italy
| | - Eleonora Gori
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Via Livornese Lato Monte, San Piero a Grado, 56122 Pisa, Italy
| | - Verena Habermaass
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Via Livornese Lato Monte, San Piero a Grado, 56122 Pisa, Italy
| | - Ilaria Lippi
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Via Livornese Lato Monte, San Piero a Grado, 56122 Pisa, Italy
| | - Simonetta Citi
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Via Livornese Lato Monte, San Piero a Grado, 56122 Pisa, Italy
| | - Caterina Puccinelli
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Via Livornese Lato Monte, San Piero a Grado, 56122 Pisa, Italy
| | - Veronica Marchetti
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Via Livornese Lato Monte, San Piero a Grado, 56122 Pisa, Italy
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Jablonski SA, Chen YX(P, Williams JE, Kendziorski JA, Smedley RC. Concurrent hepatopathy in dogs with gallbladder mucocele: Prevalence, predictors, and impact on long-term outcome. J Vet Intern Med 2024; 38:176-186. [PMID: 37921591 PMCID: PMC10800193 DOI: 10.1111/jvim.16922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Information is limited regarding the prevalence and importance of hepatic histologic abnormalities in dogs with gallbladder mucocele (GBM). OBJECTIVES To (a) report prevalence of hepatic histologic abnormalities in dogs with GBM (b) evaluate for association between hepatic abnormalities and outcome in dogs with GBM (c) evaluate whether neutrophil-to-lymphocyte ratio (NLR) differs in dogs with GBM with and without specific hepatic lesions. ANIMALS Fifty-two dogs with grossly and histologically confirmed GBM. METHODS Multicenter, retrospective study of dogs with GBM undergoing cholecystectomy with concurrent liver biopsy. Archived histological sections of gallbladder and liver evaluated by investigators blinded to data. Proportions of dogs with each histologic abnormality alive vs deceased at 1, 3, and 12 months post-cholecystectomy compared. Mann-Whitney U performed to determine if NLR differed in dogs with or without selected lesions. RESULTS 51/52 (98%, 95% CI [89%, 99%]) dogs with GBM had at least 1 hepatic histologic abnormality. Hepatic fibrosis (37/51; 73%, 95% CI [59%, 83%]), biliary hyperplasia (29/52; 56%, 95% CI [42%, 68%]), and portal inflammation (25/52; 48%, 95% CI [35%, 61%]) were most common. The proportion of dogs alive vs dead differed based on the fibrosis score at 1, 3, and 12 (P ≤ .04) months post-cholecystectomy. Dogs with hepatic necrosis (P = .006) and cholangitis/cholangiohepatitis (P = .02) had higher NLRs compared to dogs without these lesions. CONCLUSIONS AND CLINICAL IMPORTANCE Histologic abnormalities of the liver are common in dogs with GBM. A higher portal fibrosis score might be associated with shortened long-term survival after cholecystectomy for dogs with GBM. An increase in NLR might predict hepatic necrosis and cholangitis/cholangiohepatitis in dogs with GBM.
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Affiliation(s)
- Sara A. Jablonski
- Department of Small Animal Clinical SciencesCollege of Veterinary Medicine, Michigan State UniversityEast LansingMichiganUSA
| | | | - Jarod E. Williams
- Ozark Veterinary Specialty Care, 881 Animal Emergency DrSpringdaleArkansasUSA
| | - Jessica A. Kendziorski
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary MedicineMichigan State UniversityEast LansingMichiganUSA
| | - Rebecca C. Smedley
- Veterinary Diagnostic Laboratory, College of Veterinary MedicineMichigan State UniversityEast LansingMichiganUSA
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NAGAO I, TSUJI K, GOTO-KOSHINO Y, TSUBOI M, CHAMBERS JK, UCHIDA K, KAMBAYASHI S, TOMIYASU H, BABA K, OKUDA M. MUC5AC and MUC5B expression in canine gallbladder mucocele epithelial cells. J Vet Med Sci 2023; 85:1269-1276. [PMID: 37899236 PMCID: PMC10788179 DOI: 10.1292/jvms.23-0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 10/17/2023] [Indexed: 10/31/2023] Open
Abstract
Gallbladder mucocele (GBM) is one of the most common gallbladder diseases in dogs. Its pathogenesis has not yet been clarified, but excessive accumulation of a secretory gel-forming mucin, MUC5AC in the gallbladder has been reported. This study aimed to ascertain if MUC5AC overproduction resulted in mucus accumulation in the gallbladder during GBM development. Eleven dogs undergoing cholecystectomy who were pathologically diagnosed with GBM were included, and the expression level of mucins, particularly MUC5AC and MUC5B, in their gallbladder epithelial cells was compared with those in normal gallbladder epithelial cells. On reverse transcription-quantitative polymerase chain reaction screening, there was a significant difference (P<0.05) in the mRNA expression level of MUC1, but not of other mucins including MUC5AC and MUC5B, between mucocele and normal gallbladder epithelial cells. Protein expression levels were also evaluated for MUC5AC and MUC5B using immunohistochemistry. There was little immunoreactivity for MUC5AC, whereas MUC5B showed definitive staining in gallbladder epithelial cells. There was no difference in MUC5AC and MUC5B protein expression levels between mucocele and normal gallbladder epithelial cells. These data suggest that excessive production of mucin, especially MUC5AC and MUC5B, does not occur in canine GBM, and that abnormal mucus excretion, rather than excessive mucus production, may be the cause of GBM development.
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Affiliation(s)
- Itsuma NAGAO
- Department of Veterinary Internal Medicine, Graduate School
of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Kanako TSUJI
- Laboratory of Veterinary Internal Medicine, Joint Faculty of
Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Yuko GOTO-KOSHINO
- Department of Veterinary Internal Medicine, Graduate School
of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Masaya TSUBOI
- Laboratory of Veterinary Pathology, Graduate School of
Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - James K. CHAMBERS
- Laboratory of Veterinary Pathology, Graduate School of
Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Kazuyuki UCHIDA
- Laboratory of Veterinary Pathology, Graduate School of
Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Satoshi KAMBAYASHI
- Laboratory of Veterinary Internal Medicine, Joint Faculty of
Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Hirotaka TOMIYASU
- Department of Veterinary Internal Medicine, Graduate School
of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Kenji BABA
- Laboratory of Veterinary Internal Medicine, Joint Faculty of
Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Masaru OKUDA
- Laboratory of Veterinary Internal Medicine, Joint Faculty of
Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
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Morishita M, Sunden Y, Horiguchi M, Sakoya H, Yokogawa M, Ino H, Une S, Kawata M, Hosoido T, Morita T. Wavy changes in the whiskers of domestic cats are correlated with feline leukemia virus infection. BMC Vet Res 2023; 19:58. [PMID: 36871053 PMCID: PMC9985215 DOI: 10.1186/s12917-023-03610-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Feline leukemia virus (FeLV) is a retrovirus with global impact on the health of domestic cats and is usually examined by serology. In our daily clinical practice, we noticed that cats infected with FeLV often possess wavy whiskers (sinus hairs on the face). To investigate the relationship between wavy whiskers (WW) and FeLV infection, the association between the presence or absence of wavy changes in whiskers and serological FeLV infection was examined in a total of 358 cats including 56 cats possessing WW, using the chi-square test. The results of blood tests from 223 cases were subjected to multivariate analysis (logistic analysis). Isolated whiskers were observed under light microscopy, and upper lip tissues (proboscis) were subjected to histopathological and immunohistochemical analyses. RESULTS The prevalence of WW was significantly correlated with FeLV antigen positivity in the blood. Of 56 cases with WW, 50 (89.3%) were serologically positive for FeLV. The significant association between WW and serological FeLV positivity was also confirmed by multivariate analysis. In WW, narrowing, degeneration, and tearing of the hair medulla were observed. Mild infiltration of mononuclear cells in the tissues, but no degeneration or necrosis, was found. By immunohistochemistry, FeLV antigens (p27, gp70 and p15E) were observed in various epithelial cells including the sinus hair follicular epithelium of the whisker. CONCLUSIONS The data suggest that the wavy changes in whiskers, a unique and distinctive external sign on a cat's face, were associated with FeLV infection.
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Affiliation(s)
- Masataka Morishita
- Niihama Animal Hospital, 2-1-11 Wakamizu Niihama, Ehime, 792-0017, Japan.,Neovets VR Center, 3-8-15 Nakamichi, Higashinari, Osaka, 537-0025, Japan
| | - Yuji Sunden
- Laboratory of Veterinary Pathology, Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori, 680-8553, Japan.
| | - Misaki Horiguchi
- Laboratory of Veterinary Pathology, Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori, 680-8553, Japan
| | - Hirosei Sakoya
- Niihama Animal Hospital, 2-1-11 Wakamizu Niihama, Ehime, 792-0017, Japan.,Sigenobu Animal Hospital, 1054-1 Ushibuchi Touon, Ehime, 791-0213, Japan
| | - Mana Yokogawa
- Niihama Animal Hospital, 2-1-11 Wakamizu Niihama, Ehime, 792-0017, Japan
| | - Hiroyuki Ino
- Niihama Animal Hospital, 2-1-11 Wakamizu Niihama, Ehime, 792-0017, Japan
| | - Satoshi Une
- Neovets VR Center, 3-8-15 Nakamichi, Higashinari, Osaka, 537-0025, Japan
| | - Mutsumi Kawata
- Neovets VR Center, 3-8-15 Nakamichi, Higashinari, Osaka, 537-0025, Japan
| | - Taisei Hosoido
- Neovets VR Center, 3-8-15 Nakamichi, Higashinari, Osaka, 537-0025, Japan
| | - Takehito Morita
- Laboratory of Veterinary Pathology, Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori, 680-8553, Japan
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Gookin JL, Hartley AN, Aicher KM, Mathews KG, Cullen R, Cullen JM, Callahan BJ, Stowe DM, Seiler GS, Jacob ME, Arnold JW, Azcarate-Peril MA, Stauffer SH. Gallbladder microbiota in healthy dogs and dogs with mucocele formation. PLoS One 2023; 18:e0281432. [PMID: 36763596 PMCID: PMC9916591 DOI: 10.1371/journal.pone.0281432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
To date studies have not investigated the culture-independent microbiome of bile from dogs, a species where aseptic collection of bile under ultrasound guidance is somewhat routine. Despite frequent collection of bile for culture-based diagnosis of bacterial cholecystitis, it is unknown whether bile from healthy dogs harbors uncultivable bacteria or a core microbiota. The answer to this question is critical to understanding the pathogenesis of biliary infection and as a baseline to exploration of other biliary diseases in dogs where uncultivable bacteria could play a pathogenic role. A pressing example of such a disease would be gallbladder mucocele formation in dogs. This prevalent and deadly condition is characterized by excessive secretion of abnormal mucus by the gallbladder epithelium that can eventually lead to rupture of the gallbladder or obstruction of bile flow. The cause of mucocele formation is unknown as is whether uncultivable, and therefore unrecognized, bacteria play any systematic role in pathogenesis. In this study we applied next-generation 16S rRNA gene sequencing to identify the culture-negative bacterial community of gallbladder bile from healthy dogs and gallbladder mucus from dogs with mucocele formation. Integral to our study was the use of 2 separate DNA isolations on each sample using different extraction methods and sequencing of negative control samples enabling recognition and curation of contaminating sequences. Microbiota findings were validated by simultaneous culture-based identification, cytological examination of bile, and fluorescence in-situ hybridization (FISH) performed on gallbladder mucosa. Using culture-dependent, cytological, FISH, and 16S rRNA sequencing approaches, results of our study do not support existence of a core microbiome in the bile of healthy dogs or gallbladder mucus from dogs with mucocele formation. Our findings further document how contaminating sequences can significantly contribute to the results of sequencing analysis when performed on samples with low bacterial biomass.
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Affiliation(s)
- Jody L. Gookin
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
- * E-mail:
| | - Ashley N. Hartley
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Kathleen M. Aicher
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Kyle G. Mathews
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Rachel Cullen
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - John M. Cullen
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Benjamin J. Callahan
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Devorah M. Stowe
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Gabriela S. Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Megan E. Jacob
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Jason W. Arnold
- Department of Medicine, Division of Gastroenterology and Hepatology, and UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - M. Andrea Azcarate-Peril
- Department of Medicine, Division of Gastroenterology and Hepatology, and UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Stephen H. Stauffer
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
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Cordella A, Gianesini G, Zoia A, Ventura L, Bertolini G. Multi-phase MULTIDETECTOR-row computed tomographic features and laboratory findings in dogs with gallbladder rupture. Res Vet Sci 2022; 153:137-143. [PMID: 36368275 DOI: 10.1016/j.rvsc.2022.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 09/02/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
Gallbladder rupture is a life-treating condition in dogs. In human medicine, multidetector-row computed tomography (MDCT) is considered the best modality for the diagnosis of gallbladder rupture. The aims of the study were to describe MDCT features of gallbladder rupture in dogs and to determine the CT findings and laboratory data that differ between dogs with ruptured biliary tree and dogs with biliary disease with no rupture. For this single-center, cross-sectional study were considered for inclusion dogs presented from May 2010 to September 2020, with surgical diagnosis of gallbladder rupture or integrity, who underwent MDCT examination and with CBC and biochemistry results available for review. Forty-seven dogs with different diseases of the biliary tract were included. Seventeen dogs with confirmed gallbladder rupture and 30 dogs with intact gallbladder were included. Multiple MDCT findings showed statistical significance in distinguish dogs with gallbladder rupture: irregular contours of the gallbladder (p < 0.0001), discontinuation of the gallbladder wall (p = 0.0005), adhesions with adjacent organs (p = 0.005), heterogeneous enhancement of the gallbladder wall (p = 0.01), pericholecystic effusion (p = 0.001) and pericholecystic peritonitis (p = 0.001). The presence of three or more of these findings was highly indicative for gallbladder rupture (AUC = 0.921). In this study, MDCT proved to be useful in differentiating dogs with gallbladder rupture from dogs with biliary disease without rupture.
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Affiliation(s)
- Alessia Cordella
- Diagnostic and Interventional Radiology Division of San Marco Veterinary Clinic and Laboratory, Veggiano (Padova), Italy
| | - Giulia Gianesini
- Internal Medicine Division of San Marco Veterinary Clinic and Laboratory, Veggiano (Padova), Italy
| | - Andrea Zoia
- Internal Medicine Division of San Marco Veterinary Clinic and Laboratory, Veggiano (Padova), Italy
| | - Laura Ventura
- Department of Statistical Sciences, University of Padova, Via Battisti, 241 -, 35121 Padova, (Italy)
| | - Giovanna Bertolini
- Diagnostic and Interventional Radiology Division of San Marco Veterinary Clinic and Laboratory, Veggiano (Padova), Italy.
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Brough A, Caraguel C, Ciaravolo S, Stickney A. Clinical findings and assessment of factors associated with survival in dogs presenting with hyperbilirubinaemia: 115 cases in Victoria, Australia (2015-2020). Vet Rec Open 2022; 9:e42. [PMID: 35990552 PMCID: PMC9380407 DOI: 10.1002/vro2.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 06/26/2022] [Accepted: 07/07/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction Hyperbilirubinaemia is an important clinicopathological finding in canine medicine. The objectives of this study were to describe the clinical presentation and outcome of dogs with hyperbilirubinaemia; also to identify factors associated with survival. Materials and methods Retrospective study of dogs with hyperbilirubinaemia from two referral centres in South Australia (2015-2020). Signalment, clinical signs, clinicopathological data, diagnosis and outcome were obtained from searching clinical records. Univariable analysis and logistic regression modelling were used to compare outcomes and overall survival. Results A total of 115 cases were included. The most common clinical signs were vomiting (63.5%), anorexia (62.6%), lethargy (55.7%) and pyrexia (18.3%). Pre-hepatic icterus was diagnosed in 18 cases (15.7%), hepatic icterus in 51 cases (44.3%) and post-hepatic icterus in 42 cases (36.5%). The median survival time across all cases was 40 days (95% confidence interval [CI]: 9-126 days). There was an increased risk of death in dogs with serum bilirubin greater than 60 μmol/L at diagnosis (odds ratio [OR] = 3.55; 95% CI: 1.53-8.22; p-value = 0.003) and in dogs with pre-hepatic icterus compared to hepatic (OR = 4.35; 95% CI: 1.18-16.0; p-value = 0.027) and post-hepatic icterus (OR = 6.52; 95% CI: 1.67-25.5; p-value = 0.007). Conclusions Pre-hepatic icterus was associated with a significantly higher risk of death than hepatic and post-hepatic icterus. Serum bilirubin >60 μmol/L at diagnosis was associated with a significantly shorter median survival time. This cut-off may be useful in discussions with owners regarding pursuing further diagnostic investigation and treatment. Further prospective studies are needed to prove the validity of this cut-off.
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Affiliation(s)
- Abigail Brough
- Peninsula Vet Emergency and Referral HospitalMorningtonVictoriaAustralia
| | | | - Susan Ciaravolo
- Peninsula Vet Emergency and Referral HospitalMorningtonVictoriaAustralia
| | - Alison Stickney
- Peninsula Vet Emergency and Referral HospitalMorningtonVictoriaAustralia
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10
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Sambugaro B, De Gennaro C, Hattersley RD, Vettorato E. Extradural anaesthesia-analgesia in dogs undergoing cholecystectomy: A single centre retrospective study. Front Vet Sci 2022; 9:966183. [PMID: 36157172 PMCID: PMC9500543 DOI: 10.3389/fvets.2022.966183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To assess the effects of extradural anaesthesia-analgesia (EAA) in dogs undergoing cholecystectomy. Materials and methods Medical records of dogs undergoing cholecystectomy between 2011 and 2019 were retrieved and allocated to two groups depending if analgesia was provided systemically (group SA) or extradurally (EAA). Preoperative data, intraoperative antinociceptive medications, postoperative analgesia, perioperative complications, and food intake were compared. Results Overall 41 medical records were included in the study: 19 and 22 dogs were allocated to groups SA and EAA, respectively. In group EAA, an extradural catheter was placed preoperatively in 8 dogs; in the remaining, it was placed postoperatively but an extradural injection was performed preoperatively. The extradural catheter tip was between the 4th lumbar and the 10th thoracic vertebrae. Intraoperatively, nociception was more likely to occur in group SA [OR 55.42 (2.97–1,035.06)]. During the first 24 and 48 h postoperatively, more dogs in group SA required methadone [OR 24 (2.81–268.4) and OR 11.56 (2.37–45.06), respectively] and additional analgesic drugs [OR 25 (3.47–281.9) and OR 35.29 (1.86–668.2), respectively] compared to group EAA. Voluntary postoperative food intake was also significantly higher in group EAA. Clinical significance Compared to systemic analgesia, the use of extradural anaesthesia-analgesia reduced perioperative analgesic requirement and promoted postoperative food intake in dogs undergoing cholecystectomy.
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Long-Term Outcome after Cholecystectomy without Common Bile Duct Catheterization and Flushing in Dogs. Animals (Basel) 2022; 12:ani12162112. [PMID: 36009701 PMCID: PMC9405371 DOI: 10.3390/ani12162112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this study is to report outcomes of dogs undergoing cholecystectomy for gall bladder mucocele (GBM) without flushing and catheterization of the common bile duct (CBD). This is a retrospective multicentric study from three veterinary referral hospitals and included 82 dogs diagnosed with GBM. Medical records were reviewed for clinical and histopathological findings. Long-term outcome was assessed with an owner questionnaire. The common bile duct was considered normal (<4 mm), mildly dilated (5−6 mm) and moderately dilated (>7 mm) in 88%, 10% and 2.4% of dogs, respectively. Surgery was uncomplicated in 83% of dogs. Intraoperative complications were recorded in 21% of dogs, with hypotension being the most common, whereas postoperative complications were documented in 20% of dogs, with vomiting/regurgitation being the most common. Ninety-six percent of dogs that underwent cholecystectomy in this study survived to discharge. Follow-up ranged from 142 to 3930 days (median: 549 days). Eighty-five percent of dogs were alive at the time of follow-up. Dogs undergoing cholecystectomy for GBM without catheterization and flushing of the CBD have a favourable prognosis for recovery and quality of life.
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12
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Hill FI, Speelman JP, Hui KKL, Nekouei O, Beczkowski P, Barrs VR. High frequency of cholecystitis in dogs with gallbladder mucocoele in Hong Kong. Vet J 2022; 287:105881. [PMID: 35961604 DOI: 10.1016/j.tvjl.2022.105881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022]
Abstract
The aims of this retrospective study were to characterise the epidemiological, clinical, histopathological, and microbiological findings as well as surgical outcomes in dogs admitted to a specialist veterinary hospital in Hong Kong for surgical management of gallbladder mucocoele (GBM). Inclusion criteria were cases with histopathological diagnosis of GBM and accompanying abdominal imaging, serum biochemistry, bile culture, and liver biopsy histology results. Fifty-six cases met the inclusion criteria. The median age at diagnosis was 12 years (range, 5-16 years). Miniature or toy pure-breed dogs were most commonly affected, including Poodles, Pomeranians, Schnauzers, Bichon frises and Chihuahuas. However, no breed was over-represented compared with their expected proportions among annual hospital admissions. Histological evidence of cholecystitis was present in 84% of cases, including acute cholecystitis in 18%, chronic cholecystitis in 37.5%, acute on chronic cholecystitis in 28% and acute with necrosis in 6%. The most common liver lesions were cholestasis in 64%, along with portal fibrosis in 55%, oedema in 50% and bile duct hyperplasia in 50%. Bile culture was positive in 29.6% of cases. Escherichia coli and Enterobacter species were most commonly isolated. Stentrophomonas maltophili was cultured from one case. Of the 16 cases where bacteria were isolated from bile culture, 94% had evidence of chronic cholecystitis and 81% had evidence of cholangiohepatitis. Fifty dogs (89.3%) survived to discharge including 5/5 dogs with ruptured gallbladders. Of 34 dogs with follow-up data, 21/34 (61.8%) were still alive 12 months later. Gallbladder mucocoeles were frequently associated with both acute and chronic inflammation. High survival rates to discharge were achieved.
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Affiliation(s)
- F I Hill
- CityU Veterinary Diagnostic Laboratory, City University of Hong Kong, Kowloon, Hong Kong.
| | - J P Speelman
- CityU Veterinary Medical Centre, City University of Hong Kong, Sham Shui Po, Hong Kong
| | - K K L Hui
- CityU Veterinary Medical Centre, City University of Hong Kong, Sham Shui Po, Hong Kong
| | - O Nekouei
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - P Beczkowski
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - V R Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
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13
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Jaffey JA, Kreisler R, Shumway K, Lee YJ, Lin CH, Durocher-Babek LL, Seo KW, Choi H, Nakashima K, Harada H, Kanemoto H, Lin LS. Ultrasonographic patterns, clinical findings, and prognostic variables in dogs from Asia with gallbladder mucocele. J Vet Intern Med 2022; 36:565-575. [PMID: 35170083 PMCID: PMC8965224 DOI: 10.1111/jvim.16384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Gallbladder mucocele (GBM) is a common biliary disorder in dogs that can be categorized into 6 types, but the value of this classification scheme remains unknown. Cholecystectomy is associated with high death rates and warrants additional interrogation. OBJECTIVES Investigate the clinical value of ultrasonographic diagnosis of type of GBM and identify prognostic factors in dogs with GBM undergoing cholecystectomy. ANIMALS Two hundred sixteen dogs. METHODS Retrospective cohort study. Dogs with GBM diagnosed from 2014 to 2019 at 6 veterinary referral hospitals in Asia. Ultrasonogram images were reviewed and a GBM type (ie, types I-VI) assigned. RESULTS Dogs with GBM type V as compared to I (OR, 8.6; 95% CI, 2.6-27.8; P < .001) and III (OR, 10.0; 95% CI, 2.5-40.8; P = .001), and dogs with type VI compared to I (OR, 10.5; 95% CI, 1.8-61.2; P = .009) and III (OR, 12.3; 95% CI, 1.8-83.9; P = .01) were more likely to exhibit signs of biliary tract disease. Independent predictors of death after cholecystectomy included age (OR, 2.81; 95% CI, 1.41-5.59; P = .003) and intraoperative systolic blood pressure (SBP) nadir. There was an interaction between SBP nadir and gallbladder rupture; SBP nadir in dogs with (OR, 0.92; 95% CI, 0.89-0.94; P < .001) and without (OR, 0.88; 95% CI, 0.82-0.93; P < .001) gallbladder rupture. CONCLUSION AND CLINICAL IMPORTANCE Increasing developmental stage of GBM could be associated with an increased likelihood of biliary tract related clinical signs. Nadir SBP deserves further investigation as a prognostic or potentially modifiable variable, particularly in the presence of gallbladder rupture.
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Affiliation(s)
- Jared A Jaffey
- Department of Specialty Medicine, Midwestern University College of Veterinary Medicine, Glendale, Arizona, USA
| | - Rachael Kreisler
- Department of Pathology and Population Medicine, Midwestern University College of Veterinary Medicine, Glendale, Arizona, USA
| | - Kate Shumway
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, USA
| | - Yan-Jane Lee
- Graduate Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan.,National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan
| | - Chung-Hui Lin
- Graduate Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan.,National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan
| | | | - Kyoung-Won Seo
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea.,Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Hojung Choi
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea
| | - Ko Nakashima
- Japan Small Animal Medical Center, Saitama, Japan
| | | | | | - Lee-Shuan Lin
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
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14
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Wallace ML. Updates in Hepatobiliary Surgery. Vet Clin North Am Small Anim Pract 2022; 52:369-385. [DOI: 10.1016/j.cvsm.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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15
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Asakawa M, Fukuzawa M, Asakawa MG, Flanders JA. Preoperative serum C-reactive protein concentration can be used to detect gallbladder rupture in dogs with gallbladder mucocele. Am J Vet Res 2022; 83:23-32. [PMID: 34757924 DOI: 10.2460/ajvr.21.09.0141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine whether serum C-reactive protein (CRP) concentration could be used to detect gallbladder rupture (GBR) prior to surgery in dogs undergoing cholecystectomy for treatment of gallbladder mucocele (GBM). ANIMALS 45 dogs that underwent cholecystectomy because of GBM at a companion animal referral hospital from 2017 to 2020. PROCEDURES Electronic medical records were reviewed, and dogs were included if serum CRP concentration had been measured within 24 hours prior to cholecystectomy. Dogs were grouped as to whether the gallbladder was found to be ruptured or intact during surgery. Accuracy of using preoperative CRP concentration to predict GBR was compared with accuracy of abdominal ultrasonography and other preoperative blood tests. RESULTS GBR was present in 15 dogs at the time of surgery. Median preoperative CRP concentration was significantly higher in dogs with GBR (15.1 mg/dL; interquartile range, 7.4 to 16.8 mg/dL) than in dogs with an intact gallbladder (2.65 mg/dL; interquartile range, 0.97 to 13.4 mg/dL). Sensitivity, specificity, and accuracy of using preoperative CRP concentration to predict GBR were 100%, 67%, and 78%, respectively. CLINICAL RELEVANCE Measurement of preoperative CRP concentration provided excellent sensitivity and moderate specificity for detection of GBR in dogs undergoing cholecystectomy because of GBM. Accuracy of using preoperative CRP concentration for detection of GBR was not superior to the accuracy of preoperative abdominal ultrasonography. However, when CRP concentration was combined with results of ultrasonography, the sensitivity, specificity, and accuracy for detection of GBR were 100%, 93%, and 96%, respectively.
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Affiliation(s)
- Makoto Asakawa
- 1Veterinary Specialists Emergency Center, Saitama Prefecture, Japan
| | - Mayuko Fukuzawa
- 1Veterinary Specialists Emergency Center, Saitama Prefecture, Japan
| | | | - James A Flanders
- 2Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
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Jaffey JA. Canine extrahepatic biliary disease: what have we learned? J Small Anim Pract 2021; 63:247-264. [PMID: 34935155 DOI: 10.1111/jsap.13468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/01/2021] [Accepted: 12/02/2021] [Indexed: 12/07/2022]
Abstract
Extrahepatic biliary disease in dogs is commonly encountered in clinical practice worldwide. Diseases in this segment of the biliary tract are diverse and can manifest with mild clinical signs or can be life-threatening. In the last decade there have been advances in diagnostic tests, imaging modalities and therapeutic interventions as well as the identification of novel prognostic variables that could improve outcomes in dogs with extrahepatic biliary disease. Therefore, the objective of this review was to summarise clinically relevant updates of extrahepatic biliary disease in dogs.
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Affiliation(s)
- J A Jaffey
- Department of Specialty Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ, 85308, USA
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17
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Chronic Cholecystitis of Dogs: Clinicopathologic Features and Relationship with Liver. Animals (Basel) 2021; 11:ani11113324. [PMID: 34828055 PMCID: PMC8614729 DOI: 10.3390/ani11113324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary This study on the gallbladders and livers of 219 client-owned dogs provides a benchmark for future studies on chronic canine cholecystitis. The statistical evaluation of clinical data; histopathology; histochemistry; and immunohistochemistry in this report provides insight into the etiology of chronic cholecystitis in dogs Abstract (1) Background: Chronic cholecystitis of dogs has not been vigorously investigated histopathologically. In addition, the relationship between gallbladder and liver diseases is not known. (2) Methods: We aimed to provide a hallmark for canine chronic cholecystitis using clinical data, histopathology, histochemistry, immunohistochemistry, and statistical analysis. (3) Results: Our investigation of 219 ultrasonographically abnormal surgically resected canine gallbladders revealed 189 cases (86.3%) of mucosal lymphoplasmacytic infiltration (chronic cholecystitis). Sludge, a gravity-dependent or nondependent fine granular hyperechoic material, was more prevalent (105/219, 47.9%) than mucocele (51/219, 23.2%) in this cohort. Mucosal lymphoid follicles were detected in 68/219 cases (31%), suggesting the influence of long-standing antigenic stimulation. Bacteria were histochemically detected in 41/60 (68.3%) of heavily inflamed gallbladders, 18/129 (14%) of lightly inflamed, and 3/18 (16.7%) of uninflamed gallbladders, suggesting a possible relationship between bacteria and chronic cholecystitis. Simultaneous liver biopsies revealed mild or no inflammation, changes consistent with primary portal vein hypoplasia, and mild hepatocellular degeneration. (4) Conclusions: Based on the results of our statistical analysis, we conclude that canine chronic cholecystitis is a long-standing inflammatory process of unknown (but possibly bacterial) etiology and that liver pathology is unlikely the cause of chronic cholecystitis in dogs.
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Pavlick M, DeLaforcade A, Penninck DG, Webster CRL. Evaluation of coagulation parameters in dogs with gallbladder mucoceles. J Vet Intern Med 2021; 35:1763-1772. [PMID: 34196054 PMCID: PMC8295708 DOI: 10.1111/jvim.16203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 06/05/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Gallbladder mucocele (GBM) is a common biliary disorder in dogs. Limited information is available on the coagulation status of dogs with GBM. HYPOTHESIS/OBJECTIVES To determine patterns of coagulation alterations in dogs with GBM and correlate them with clinicopathologic abnormalities and ultrasonographic findings of disease severity. ANIMALS Twenty-three dogs with GBM identified on ultrasound examination were prospectively enrolled. METHODS At the time of GBM identification, blood and urine were collected for CBC, serum biochemical panel, urinalysis, prothrombin time, activated partial thromboplastin time (aPTT), factor VIII, protein C (PC), von Willebrand's factor (vWF), antithrombin activity, fibrinogen, D-dimers, and thromboelastrography (TEG). Gallbladder mucoceles were classified into ultrasound types 1 to 5. Medical records were reviewed for clinical presentation, underlying conditions and to determine if systemic inflammatory response syndrome (SIRS) was present. RESULTS Based on TEG parameters, maximal amplitude, and G, 19/23 (83%) of dogs with GBM had evaluations consistent with hypercoagulability. On plasma-based coagulation testing, dogs with GBM had increased total PC activity (20/23, 87%), fibrinogen (9/23, 39%), platelet count (9/23, 39%), and D-dimers (6/15, 40%) as well as prolongations in aPTT (9/22, 41%) and low vWF activity (5/21, 24%). No correlation was found between TEG G value and any coagulation or clinical pathology variables, ultrasound stage of GBM or disease severity as assessed by the presence of SIRS. CONCLUSIONS AND CLINICAL IMPORTANCE Dogs with ultrasonographically identified GBM have changes in whole blood kaolin-activated TEG supporting a hypercoagulable state although traditional plasma-based coagulation testing suggests that a complex state of hemostasis exists.
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Affiliation(s)
- Michelle Pavlick
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
| | - Armelle DeLaforcade
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
| | - Dominique G Penninck
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
| | - Cynthia R L Webster
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
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Putterman AB, Selmic LE, Kindra C, Duffy DJ, Risselada M, Phillips H. Influence of normograde versus retrograde catheterization of bile ducts in dogs treated for gallbladder mucocele. Vet Surg 2021; 50:784-793. [PMID: 33797102 DOI: 10.1111/vsu.13632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 01/17/2021] [Accepted: 03/22/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine the influence of normograde (NG) versus retrograde (RG) catheterization of the cystic duct and common bile duct (CBD) in dogs with gallbladder mucoceles (GBM) treated with open cholecystectomy. STUDY DESIGN Retrospective study. ANIMALS Dogs (n = 117) with GBM. METHODS Medical records were reviewed for signalment, history, clinical laboratory and diagnostic imaging findings, details of surgery including catheterization method, complications, and outcome. Long-term follow-up data were obtained by telephone or electronic communication. Relationships between catheterization method and clinical variables and outcome were evaluated. RESULTS Dogs catheterized RG were more likely to experience any postoperative complication (p = .0004) including persistence of gastrointestinal signs (p = .0003). Survival to discharge and long-term survival did not differ by group (p = .23 and p = .49). Total bilirubin (TB) decreased by 70.3% after NG catheterization compared to 39.1% after RG catheterization (p = .03) and increased in 14.9% dogs catheterized NG and 38.0% dogs catheterized RG (p = .004). The presence of a diplomate surgeon at surgery resulted in decreased incidences of any perioperative or postoperative complication (p = .003 and p = .05). CONCLUSION Retrograde catheterization was associated with more postoperative concerns than NG catheterization, but similar survival times. Surgery should be performed by diplomates experienced in biliary surgery to minimize complications. CLINICAL SIGNIFICANCE Although both NG and RG techniques to catheterize the cystic duct and CBD are options for treatment of GBM with low mortality, results of this study provide some evidence to recommend NG over RG catheterization.
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Affiliation(s)
- Allison B Putterman
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Laura E Selmic
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Cameron Kindra
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Daniel J Duffy
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Marije Risselada
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Heidi Phillips
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
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Thompson BJ, Sherman RA. Comprehensive Review of Biliary Peritonitis. Top Companion Anim Med 2021; 44:100532. [PMID: 33781985 DOI: 10.1016/j.tcam.2021.100532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 11/26/2022]
Abstract
Biliary peritonitis is a growing concern in the canine patient and a thorough understanding of the disease will lead to better treatment outcomes. This article reviews the human and veterinary literature pertaining to biliary peritonitis including both scientific reviews and original publications. Compared to human medicine, biliary peritonitis can be difficult to diagnose preoperatively. Multiple risk factors exist increasing the likelihood of development of biliary peritonitis. Treatment recommendations center on stabilization, surgical cholecystectomy, and postoperative supportive care. Clinically, further studies on treatment and prevention in veterinary medicine are warranted.
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Friesen SL, Upchurch DA, Hollenbeck DL, Roush JK. Clinical findings for dogs undergoing elective and nonelective cholecystectomies for gall bladder mucoceles. J Small Anim Pract 2021; 62:547-553. [PMID: 33587301 DOI: 10.1111/jsap.13312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The purpose of this study was to describe elective and nonelective post-cholecystectomy complications and mortality rates in dogs with a gall bladder mucocele. The secondary purpose was to report complications and mortality rates for different methods of common bile duct catheterisation. MATERIALS AND METHODS A multi-institutional retrospective case series was performed to identify dogs with a gall bladder mucocele between 2004 and 2018 that underwent a cholecystectomy. Dogs were classified into nonelective or elective based on the presence or absence, respectively, of gall bladder rupture, biliary duct distension, clinical signs or hyperbilirubinemia. Each cholecystectomy was classified into three groups: duodenotomy and retrograde catheterisation, normograde catheterisation or no catheterisation. Complications were divided into four grades based on increasing severity and mortality rates were assessed for each. RESULTS The mortality rate was 2 (6%) out of 31 for dogs undergoing an elective cholecystectomy and 21 (23%) out of 90 for dogs undergoing a nonelective cholecystectomy. The complication rate was 52% for the elective cholecystectomy and 50% for nonelective cholecystectomy. The majority of the complications in the elective category were grade 1 (mild). Post-operative hyperthermia developed in 35% of dogs that had a duodenotomy and retrograde common bile duct catheterisation, in 4% of dogs with a normograde common bile duct catheterisation and in 7% of dogs that did not have the common bile duct catheterised. CLINICAL SIGNIFICANCE Elective cholecystectomy in dogs with a gall bladder mucocele in this study carried a low mortality rate and a relatively high frequency of minor complications.
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Affiliation(s)
- S L Friesen
- Department of Clinical Science, Kansas State University, Manhattan, Kansas, 66506, USA
| | - D A Upchurch
- Department of Clinical Science, Kansas State University, Manhattan, Kansas, 66506, USA
| | - D L Hollenbeck
- Department of Clinical Science, Texas A&M University, College Station, Texas, 77843, USA
| | - J K Roush
- Department of Clinical Science, Kansas State University, Manhattan, Kansas, 66506, USA
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Lindaberry C, Vaden S, Aicher KM, Seiler G, Robertson J, Cianciolo R, Yang C, Gookin JL. Proteinuria in dogs with gallbladder mucocele formation: A retrospective case control study. J Vet Intern Med 2021; 35:878-886. [PMID: 33547696 PMCID: PMC7995360 DOI: 10.1111/jvim.16051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/22/2022] Open
Abstract
Background Proteinuria is an independent risk factor for morbidity and mortality in dogs. An association between proteinuria and gallbladder mucocele formation in dogs is unknown. Objective Determine if gallbladder mucocele formation or clinicopathologic comorbidities are associated with proteinuria. Animals Twenty‐five dogs with mucocele formation and 25 breed and age‐matched control dogs from a prior study. Methods Retrospective case control study. Proteinuria defined by calculated urine dipstick protein concentration (mg/mL) to urine specific gravity (USG) ratio. Clinicopathologic findings, postcosyntropin cortisol concentration, thyroid function profile, and illness severity score were recorded. Results Median urine dipstick protein concentration to USG ratio and number of dogs having a ratio ≥1.5 were significantly higher for dogs with mucocele formation compared to control dogs. Proteinuria was not significantly associated with CBC or serum biochemistry profile abnormalities but increased in relation to severity of illness. Conclusions and Clinical Importance Gallbladder mucocele formation is significantly associated with proteinuria in dogs. Diagnosis and treatment of proteinuria in dogs with mucocele formation might minimize long term kidney morbidity in these patients.
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Affiliation(s)
- Crystal Lindaberry
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Shelly Vaden
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Kathleen M Aicher
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA.,Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.,Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina, USA
| | - Gabriela Seiler
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - James Robertson
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Rachel Cianciolo
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Ching Yang
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Jody L Gookin
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
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Miceli DD, Vidal VP, Blatter MFC, Pignataro OP, Castillo VA. Fenofibrate treatment for severe hypertriglyceridemia in dogs. Domest Anim Endocrinol 2021; 74:106578. [PMID: 33137654 DOI: 10.1016/j.domaniend.2020.106578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/12/2020] [Accepted: 09/30/2020] [Indexed: 12/13/2022]
Abstract
Lipid disorders are relatively common in dogs. Hyperlipidemia can be primary or secondary to other diseases. In humans, fenofibrate is used to control hypertriglyceridemia. In dogs, there are no studies evaluating fenofibrate in hypertriglyceridemia. The aim of the study was to evaluate the safety and efficacy of fenofibrate to control severe hypertriglyceridemia in dogs. A total of 124 dogs (n = 124) with severe hypertriglyceridemia (>300 mg/dL, 3.39 mmol/L) were randomly distributed in the fenofibrate group (n = 64) and the diet group (n = 60). Dogs of the fenofibrate group were treated with fenofibrate (10 mg/Kg) once daily. Dogs of the diet group were treated with low-fat diet (10%). Serum triglycerides (TGs), total cholesterol (TC), liver enzymes, and creatine kinase concentrations were evaluated, before and after 1 mo of medical or dietary treatment. Triglyceride concentrations were reduced with fenofibrate (P < 0.001), and 85.93% of the dogs normalized their levels. Triglyceride concentrations also decreased with low-fat diet (P < 0.001), but only 26.6% of the dogs normalized their levels. Triglyceride concentrations were reduced with fenofibrate (P < 0.01) and with low-fat diet (P < 0.01). Of the cases with hypercholesterolemia, 53.7% and 50% of the dogs normalized their TC concentrations, with fenofibrate and diet, respectively. No significant adverse effects were observed (3% showed diarrhea). Fenofibrate was safe and effective in reducing and normalizing TG concentrations in dogs with severe hypertriglyceridemia, regardless of the cause of hyperlipidemia. The low-fat diet was effective in reducing, but not normalizing, TG concentrations. Fenofibrate and low-fat diet were effective in reducing TC concentrations. This is the first study evaluating fibrates in dogs with severe hypertriglyceridemia and comparing results with a low-fat diet.
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Affiliation(s)
- D D Miceli
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales, U. de Endocrinología-Hospital Escuela de Medicina Veterinaria, Buenos Aires, Argentina; CONICET, Laboratorio de Endocrinología Molecular y Transducción de Señales, Instituto de Biología y Medicina Experimental, Buenos Aires, Argentina.
| | - V P Vidal
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales, U. de Endocrinología-Hospital Escuela de Medicina Veterinaria, Buenos Aires, Argentina
| | - M F C Blatter
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales, U. de Endocrinología-Hospital Escuela de Medicina Veterinaria, Buenos Aires, Argentina
| | - O P Pignataro
- CONICET, Laboratorio de Endocrinología Molecular y Transducción de Señales, Instituto de Biología y Medicina Experimental, Buenos Aires, Argentina
| | - V A Castillo
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales, U. de Endocrinología-Hospital Escuela de Medicina Veterinaria, Buenos Aires, Argentina
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24
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Jaffey JA, Matheson J, Shumway K, Pacholec C, Ullal T, Van den Bossche L, Fieten H, Ringold R, Lee KJ, DeClue AE. Serum 25-hydroxyvitamin D concentrations in dogs with gallbladder mucocele. PLoS One 2020; 15:e0244102. [PMID: 33326487 PMCID: PMC7743984 DOI: 10.1371/journal.pone.0244102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/02/2020] [Indexed: 11/25/2022] Open
Abstract
Gallbladder mucocele (GBM) is a common biliary disorder in dogs. Gallbladder hypokinesia has been proposed to contribute to its formation and progression. The specific cause of gallbladder stasis in dogs with GBM as well as viable treatment options to resolve dysmotility remains unknown. Vitamin D deficiency is one of the many potential causes of gallbladder hypokinesia in humans and repletion results in complete resolution of stasis. Improving our understanding of the relationship between serum vitamin D and GBM could help identify dogs as a model for humans with gallbladder hypokinesia. Furthermore, this relationship could provide insight into the pathogenesis of GBM and support the need for future studies to investigate vitamin D as a novel treatment target. Therefore, goals of this study were i) to determine if serum 25-hydroxyvitamin(OH)D concentrations were decreased in dogs with GBM, ii) if serum 25(OH)D concentrations were different in clinical versus dogs subclinical for GBM, and iii) to determine if serum 25(OH)D concentrations could predict the ultrasonographic type of GBM. Sixty-two dogs (clinical, n = 26; subclinical, n = 36) with GBM and 20 healthy control dogs were included in this prospective observational study. Serum 25(OH)D concentrations were measured with a competitive chemiluminescence immunoassay. Overall, dogs with GBM had lower serum 25(OH)D concentrations than control dogs (P = 0.004). Subsequent subgroup analysis indicated that this difference was only significant in the subclinical group compared to the control dogs (P = 0.008), and serum 25(OH)D concentrations did not significantly differ between dogs clinical for GBM versus subclinical or control dogs, indicating that inflammatory state in clinical dogs was not the major constituent of the observed findings. Decreasing serum 25(OH)D concentrations, but not clinical status, was associated with a more advanced developmental stage of GBM type determined by ultrasonography. Our results indicate that vitamin D has a role in dogs with GBM. Additional studies are needed to assess if reduced vitamin D in dogs with GBM is a cause or effect of their biliary disease and to investigate if vitamin D supplementation could be beneficial for dogs with GBM.
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Affiliation(s)
- Jared A. Jaffey
- Department of Specialty Medicine, Midwestern University College of Veterinary Medicine, Glendale, Arizona, United States of America
- * E-mail:
| | - Jodi Matheson
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, United States of America
| | - Kate Shumway
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, United States of America
| | - Christina Pacholec
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, United States of America
| | - Tarini Ullal
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - Lindsay Van den Bossche
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan, Utrecht, The Netherlands
| | - Hille Fieten
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan, Utrecht, The Netherlands
| | - Randy Ringold
- VDI Laboratory, LLC, Simi Valley, California, United States of America
| | - Keun Jung Lee
- Department of Pathology and Population Medicine, Midwestern University College of Veterinary Medicine, Glendale, Arizona, United States of America
| | - Amy E. DeClue
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, United States of America
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Hattersley R, Downing F, Gibson S, Demetriou J, Elmenhorst K, Kulendra N, Mielke B, Woods S. Impact of intra-operative hypotension on mortality rates and post-operative complications in dogs undergoing cholecystectomy. J Small Anim Pract 2020; 61:624-629. [PMID: 32845022 DOI: 10.1111/jsap.13199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To report the mortality rate within a cohort of dogs undergoing cholecystectomy and investigate the impact of intra-operative hypotension on mortality. MATERIALS AND METHODS Clinical records at five UK referral centres were reviewed for dogs undergoing cholecystectomy. Data collected included presenting signs, pre-operative blood test results, intra-operative data including frequency and duration of hypotension and the incidence and type of post-operative complications. RESULTS Data from 119 dogs were included. Sixteen dogs (13%) died before discharge and by 28 days after surgery the total mortality was 19 dogs (17%). Hypotension lasting over 10 minutes during general anaesthesia occurred in 65 dogs (54.6%), with a mean ± sd duration of 36.1 ± 30.0 minutes. Intra-operative hypotension or the number of hypotensive episodes did not appear to be associated with in-hospital or 28-day mortality. American Society of Anaesthesiologists grade (of fitness for surgery) was significantly associated with both in-hospital and 28-day mortality on univariable analysis, as were post-operative hypoproteinaemia, ileus and pancreatitis. However on multivariable analysis, only ileus and pancreatitis were found to significantly impact mortality. CLINICAL SIGNIFICANCE Dogs presenting with a higher American Society of Anaesthesiologists grade appear to have a higher risk of mortality, although intra-operative hypotension did not appear to be part of this risk.
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Affiliation(s)
| | - F Downing
- Davies Veterinary Specialists, Hertfordshire, UK
| | - S Gibson
- Davies Veterinary Specialists, Hertfordshire, UK
| | | | - K Elmenhorst
- Anderson Moores Veterinary Specialists, Hampshire, UK
| | - N Kulendra
- North Downs Specialist Referrals, Surrey, UK
| | - B Mielke
- Royal Veterinary College, Hertfordshire, UK
| | - S Woods
- Veterinary Specialists Scotland, Livingston, UK
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26
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García San José P, Arenas Bermejo C, Clares Moral I, Cuesta Alvaro P, Pérez Alenza MD. Prevalence and risk factors associated with systemic hypertension in dogs with spontaneous hyperadrenocorticism. J Vet Intern Med 2020; 34:1768-1778. [PMID: 32614466 PMCID: PMC7517838 DOI: 10.1111/jvim.15841] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 12/14/2022] Open
Abstract
Background Systemic hypertension (SH) is common in dogs with hyperadrenocorticism (HAC) however there are not many studies assessing its prevalence and risk factors. Objectives To determine the prevalence and severity of SH in dogs with HAC and its association with clinical and laboratory findings to identify potential risk factors. Animals Sixty‐six client owned dogs with spontaneous HAC. Methods Retrospective cross‐sectional study. Medical records of dogs with HAC were reviewed. Systolic blood pressure (SBP) was measured using Doppler ultrasonography. Clinical signs, physical examination findings and clinicopathologic data (CBC, serum biochemistry and electrolytes, urinalysis and urinary culture, and adrenal function tests) were reviewed for analysis. Results Prevalence of SH (≥150 mm Hg) was 82% (54/66) and prevalence of severe SH (≥180 mm Hg) was 46% (30/66). All dogs with thrombocytosis had SH (P = .002), and a platelet count ≥438 × 103/μL was 100% specific and 61.1% sensitive to predict SH (AUC = .802, P = .001). Median potassium levels were lower in hypertensive dogs (4.1 mEq/L, range 3.1‐5.4 mEq/L) than in normotensive ones (4.5 mEq/L, range 4.0‐5.0 mEq/L) (P = .007). Dogs with UPC ≥ 0.5 had higher median SBP than those without proteinuria (P = .03). Dogs with concurrent diabetes mellitus seemed to have a reduced risk of SH (OR = .118, 95%CI = .022‐.626, P = .02). Conclusions and Clinical Importance Systemic hypertension is common in dogs with HAC and is frequently severe. Blood pressure should be routinely assessed in these dogs, especially if thrombocytosis, proteinuria or low potassium concentrations are present.
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Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | | | - Irene Clares Moral
- Veterinary Teaching Hospital Complutense, Complutense University of Madrid, Madrid, Spain
| | - Pedro Cuesta Alvaro
- Data Processing Center, Department of Political and Public Administration Sciences II, Political Sciences Faculty, Complutense University of Madrid, Madrid, Spain
| | - María Dolores Pérez Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
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